WILMINGTON, MA — Below is a recent Wilmington Little League game summary:Single A: Cardinals vs. Astros on Monday, May 14 at Glen Road FieldThe Astros came out swinging in a single A game vs the Cardinals. Jake Gryglik and Jackson Cipolle led the game off with two big hits to get the Astros offense going. They set the pace for a strong offensive performance by the Astros. On the defensive side, CJ Morad made his season debut behind the plate and did a fine job defensively. Dylan Costantiello pitched the final inning handling the big bats of the Cardinals by striking out the side to end the game. The Cardinals looked sharp throughout the game, getting a great pitching performance by Patrick Moriarty and gold-glove caliber defense from Spencer Walker, Zach Maiella, and Sean Theodos. The Cardinals offensive charge was led by leadoff hitter Josh Lopez, who was followed by a series of screeching hits and great at bats from Brendan Cohen, Griffin Crowe, Tommy MacGilvary, and Matthew Norton. Meanwhile the defense was anchored by great defense behind the dish from Justice Eutsay, Max Glazer, and Tommy Demers. (NOTE: Summaries provided by the Wilmington Little League.)Like Wilmington Apple on Facebook. Follow Wilmington Apple on Twitter. Follow Wilmington Apple on Instagram. Subscribe to Wilmington Apple’s daily email newsletter HERE. Got a comment, question, photo, press release, or news tip? Email email@example.com.Share this:TwitterFacebookLike this:Like Loading… RelatedWilmington Little League’s Latest Game SummariesIn “Sports”Wilmington Little League’s Latest Game SummariesIn “Sports”Wilmington Little League’s Latest Game SummariesIn “Sports”
A red alert has been issued in Coimbatore where the suspected terrorists might be holed up.IANSThe Tamil Nadu Police has sounded a high alert across the state after information was received that a group of six Lashkar-e-Taiba (LeT) terrorists have infiltrated into Tamil Nadu through Sri Lanka.There was an intelligence input that a group of terrorists, including a Pakistani national and five people from Sri Lanka, were planning to carry out a possible terror attack. Security has been beefed up at all important installations and public places like bus stands, railway stations, temples, markets, malls and all government offices.With a heavy deployment of patrolling forces at every nook and corner of prominent places in Tamil Nadu, extensive checking was carried out using a metal detector and sniffer dogs. Police personnel across all-district in the state have been asked to stay vigilant to prevent any untoward incident.A red alert has been issued in Coimbatore where the police suspect the terrorists might be holed up. The Coimbatore police are scanning the city railway station with the help of sniffer dogs and also checking all departing trains. It has been reported that the Coimbatore city police have released photographs of two possible terrorist suspects who have intruded Tamil Nadu. The Coimbatore city police have released photographs of two possible terrorist suspects.ReutersSpeaking to news agency IANS, Chennai Police Commissioner AK Viswanathan confirmed that an intelligence alert has been received that six Lashkar terrorists have entered Tamil Nadu, adding that storming operations may be carried out to nab the infiltrators.Based on the alert, the Chennai Commissioner of Police has said that deployment of police personnel have been increased and necessary precautions have been put in place. Jaish terrorist, Mudasir Ahmad Khan who masterminded Pulwama attack killed in Tral encounter Close IBTimes VideoRelated VideosMore videos Play VideoPauseMute0:01/0:59Loaded: 0%0:01Progress: 0%Stream TypeLIVE-0:58?Playback Rate1xChaptersChaptersDescriptionsdescriptions off, selectedSubtitlessubtitles settings, opens subtitles settings dialogsubtitles off, selectedAudio Trackdefault, selectedFullscreenThis is a modal window.Beginning of dialog window. Escape will cancel and close the window.TextColorWhiteBlackRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentBackgroundColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyOpaqueSemi-TransparentTransparentWindowColorBlackWhiteRedGreenBlueYellowMagentaCyanTransparencyTransparentSemi-TransparentOpaqueFont Size50%75%100%125%150%175%200%300%400%Text Edge StyleNoneRaisedDepressedUniformDropshadowFont FamilyProportional Sans-SerifMonospace Sans-SerifProportional SerifMonospace SerifCasualScriptSmall CapsReset restore all settings to the default valuesDoneClose Modal DialogEnd of dialog window. COPY LINKAD Loading …
Damage is seen at St. Sebastian Catholic Church, after bomb blasts ripped through churches and luxury hotels on Easter, in Negambo, Sri Lanka 22 April, 2019. Photo: ReutersAuthorities lifted a curfew in Sri Lanka on Monday, a day after a string of bombings at churches and luxury hotels across the Indian Ocean island killed 290 people and wounded about 500, but there were warnings more attacks were possible.There was still no claim of responsibility for the Easter Sunday attacks on two churches and four hotels in and around Colombo, the capital of predominantly Buddhist Sri Lanka, and a third church on the South Asian nation’s northeast coast.A government source said President Maithripala Sirisena, who was abroad when the attacks happened, had called a meeting of the National Security Council early on Monday. Prime minister Ranil Wickremesinghe would attend the meeting, the source said.Sri Lankan military who were clearing the route from Colombo airport late on Sunday in preparation for Sirisena’s return found a homemade bomb near the departure gate, an air force spokesman said.They disposed of the device in a controlled explosion, the spokesman said.There were fears the attacks could spark a renewal of communal violence, with police also reporting late on Sunday there had been a petrol bomb attack on a mosque in the northwest and arson attacks on two shops owned by Muslims in the west.Sri Lanka was at war for decades with Tamil separatists but extremist violence had been on the wane since the civil war ended 10 years ago.The South Asian nation of about 22 million people has Christian, Muslim and Hindu populations of between about eight and 12 per cent.The U.S. State Department issued a revised travel warning that said “terrorist groups” were continuing to plot possible attacks.”Terrorists may attack with little or no warning,” it said in the revised warning, which was dated Sunday U.S. time. The warning level was set at two on a scale where four means do not travel.Possible targets included tourist locations, transportation hubs, shopping malls, hotels, places of worship, airports and other public areas, it said.ARMED GUARDSThe island-wide curfew imposed by the government was lifted early on Monday, although there was uncharacteristically thin traffic in the normally bustling capital.Soldiers armed with automatic weapons stood guard outside major hotels and the World Trade Centre in the business district, where the four hotels were targeted on Sunday, according to a Reuters witness.Scores of people who were stranded overnight at the main airport began making their way home as restrictions were lifted.The government also blocked access to social media and messaging sites, including Facebook and WhatsApp, making information hard to gather.Wickremsinghe acknowledged on Sunday that the government had some prior information about possible attacks on churches involving a little-known Islamist group but said ministers had not been told.Sri Lankans accounted for the bulk of the 290 people killed and 500 wounded, although government officials said 32 foreigners were also killed. These included British, US, Turkish, Indian, Chinese, Danish, Dutch and Portuguese nationals.A British mother and son eating breakfast at the luxury Shangri-La hotel were among those killed, Britain’s The Telegraph newspaper reported.One Australian survivor, identified only as Sam, told Australia’s 3AW radio the hotel was a scene of “absolute carnage”.He said he and a travel partner were also having breakfast at the Shangri-La when two blasts went off. He said he had seen two men wearing backpacks seconds before the blasts.”There were people screaming and dead bodies all around,” he said. “Kids crying, kids on the ground, I don’t know if they were dead or not, just crazy.”There were similar scenes of carnage at two churches in or near Colombo, and a third church in the northeast town of Batticaloa, where worshippers had gathered for Easter Sunday services. Pictures from the scene showed bodies on the ground and blood-spattered pews and statues.Dozens were killed in one of the blasts at the Gothic-style St. Sebastian church in Katuwapitiya, north of Colombo. Police said they suspected that blast was a suicide attack.Three police officers were also killed when security forces raided a house in Colombo several hours after the attacks.Police reported an explosion at the house.
Listen at WEAA Live Stream: http://amber.streamguys.com.4020/live.m3uBaltimore City officials, including the mayor, city council president, comptroller and city council members are all receiving a pay raise next year. Yet, some argue they haven’t earned it. We’ll talk to Sun reporter Luke Broadwater and community activist Elder C.D. Witherspoon about the issue. And we’ll open the phone lines for the opinions of our listeners: 410.319.8888These stories and more coming up this evening on AFRO’s First Edition with Sean Yoes.
Holy cow!!! Delhi this weekend made this expression towards a philanthropic cause (which was saving our Indian desi cow). How? By organising an exhibition plus fest centered on a conscious awakening towards going back to nature and preserving nature for our own happy and healthy future.Organised at Select City Walk, Saket, the Ahimsa Bazar or Holy Cow Music Fest, was organised by Holy Cow Foundation. It had stalls opened from 11 am till 10 pm aimed at promoting products made from cowdung (manure, dhoopbati, agnihotra samidha, air purifier kit etc) and urine (ark, pesticide, phenyel etc.); the foundation is working towards enabling sustainability of the cow and creating awareness about apathetic condition of our domestic animals. Also Read – ‘Playing Jojo was emotionally exhausting’Visitors could select from a sumptuous menu consisting of vegetarian and vegan food and vegan ice-cream. Also, there was choice of organic vegetables and products as well as ayurveda and Holy Cow panchgavya health products. For the nature conscious, there were stalls on home composting units and organic compost and for those with literary interest, there were books on display by Indological book store. The festival also had some entertainment value to it with scintillating performances by the snake charmers sans the live snakes and kajri sangeet. For the classically attuned, there were breathtaking jugalbandi on table and the lion dance of the north east. Also Read – Leslie doing new comedy special with NetflixThe music extravaganza continued till late in the evening with rock Kirtan by Vraj Vadhu group of ISKON, including street plays and several other performances.Covered with glee and fun, the event had an underlying message which highlighted the following points- Stop cow slaughter. Stop any kind of animal slaughter for food and pleasure and respect all forms of life and live with nature. Encourage farmers to produce organic products by creating a demand for them and use cow milk, curd and ghee in your homes since these are ambrosia for humans amongst others The major concern marked was indiscriminate slaughter of cows to export meat (in our country everyday 50,000 cows are being slaughtered) and excessive use of chemical fertilizers in agriculture (today Punjab is known as the cancer capital of India) have become the major cause of growing instance of women becoming barren and men becoming impotent, rising graphs of diseases, mental stress and disorders, disorientation of youth and growing aggression in our society.This is the second time the festival is being held and the response was quite heartening.
People who received bite count feedback ate less and reduced their overall intake during a meal, the findings showed. “It was found that the presence of bite count feedback led to a reduction in overall consumption. This finding is consistent with current literature that shows feedback on consumption leads people to consume less,” explained Phillip Jasper from Clemson University in South Carolina, US. The results were published in the Journal of the Academy of Nutrition and Dietetics. For the study, investigators recruited young adults to consume a meal in the laboratory. Also Read – ‘Playing Jojo was emotionally exhausting’In one of the experiments, some participants were outfitted with bite count feedback devices and given either a small or large plate. The group that received bite count feedback significantly reduced their intake regardless of plate size, although, those given larger plates still consumed more than those given smaller plates. “We want people to be mindful of what they’re doing. That’s what’s really important. We want them to be mindful of their eating, and bite count feedback is a way to keep people mindful of their eating behaviours,” Jasper said.Knowing the number of bites is much less abstract than knowing the number of calories. “Self-monitoring is one of the cornerstones of successful weight loss,” Jasper said.
<a href=”http://www.etbtravelnews.global/click/1a6ad/” target=”_blank”><img src=”http://adsvr.travelads.biz/www/delivery/avw.php?zoneid=10&cb=INSERT_RANDOM_NUMBER_HERE&n=a5c63036″ border=”0″ alt=””></a> Source = e-Travel Blackboard: W.X While largely being a domestic US ski destination over the last two years Telluride Ski Resort has also seen growth in interest from international markets, and this year at the annual ski expo, it’s committed to its own dedicated stand.“It’s a great time to reintroduce the Telluride brand internationally,” remarks Estrella Woods, Telluride Ski Resort International Sales Manager. “Right now 5-6% of our visitors are international travellers.”“We’ve found that the biggest international market is Australia,” she continues. “Due to interest Telluride had its own stand at this year’s Snow Travel Expo [in both Sydney and Melbourne].”Attending the show for the second time, last year under the Colorado banner, Telluride Ski Resorts also has a raft of travel trade centric promotions scheduled, with agent seminars including the Ski USA event as well as the Tourplan educational evening coming up next week.A 2011 travel agents famil is also in the works, with more information to come in the next few months.“There are a few new products that we’ve recently introduced… one of the major projects has been the Revelation Bowl on the back of the mountain.”Others include new properties both in ski-in/ski-out Mountain Village as well as the township, and new terrain.One of the key messages of this year’s trade mission will be highlighting the ease of access from Australia’s east coast with United Airlines, connecting at Los Angeles and flying to regional airport Montrose, from which the ski village is a one and a half hour shuttle.
October 26, 2009 After a week of intensive composing and rehearsals, Difference Skies delivered their final performance on Saturday October 24, 2009. On the night of the performance, the Colly Soleri Music Amphitheater was illuminated under the night sky and the audience huddled together around the amphitheater. The musicians and visual artists together created a stunning tapestry of improvised and composed space music, ambient, experimental, and electronic, mixed with interactive video synthesis, for the audience. [photo: Alfonso Elia & text: Anna Tran] After the formal part of the program and a brief intermission, the artists played numerous spontaneously improvised pieces, stirring the awe and imagination of the audience. [photo: tt & text: Anna Tran] The Different Skies performance was absolutely astounding. Thank you and congratulations to all who helped bring this wonderful performance together. We hope to see you all again next year! [photo: Alfonso Elia & text: Anna Tran]
Andrew BarronGerman cable operator Primacom has named Com Hem chairman and former Virgin Media COO Andrew Barron as chairman, replacing Wolf Waschkuhn.Waschkuhn will stay with the company and remains a member of the board. Barron is the third senior cable network executive to join the primacom Board in recent months with Marcel Nijhoff, previously the Chief Commercial Officer of Ziggo, joining in January 2015 and Renaat Berckmoes, the former Chief Financial Officer of Telenet, joining in November 2014.Joachim Grendel, primacom CEO, said: “We are delighted to welcome Andrew as the new Chairman of our Board. His extensive experience of the European cable media sector will complement that of our newest Board members Renaat and Marcel and be of great benefit to the business as we continue with our successful growth strategy. Our ability to attract three such senior cable media executives to the Board reflects the significant strategic progress made by primacom over the last few years, as demonstrated most recently in the publication of our results for 2014 which showed accelerated growth in revenues, earnings and customer numbers.”
Health care in the U.S. Virgin Islands remains in a critical state, five months after Hurricane Irma and Hurricane Maria pummeled the region. The only hospital on St. Thomas, the Schneider Regional Medical Center, serves some 55,000 residents between the islands of St. Thomas and St. John. Schneider’s facilities suffered major structural damage, forcing a decrease in its range of services, mass transfers of its patients, staff departures and significant losses in revenue. Only about one-third of the beds are currently available for patient care.In early September, when Irma hit the Virgin Islands, most of Schneider’s staff members were on duty. At the height of the storm, a large window on the hospital’s top floor gave out. “You had winds of 175, 180 miles per hour whipping through here,” says the hospital’s Vice President Darryl Smalls.The screws holding the window in place failed. The window itself, made from hurricane impact glass, remained intact. It’s here, leaning against a nursing station that’s now in shambles. Ceiling panels are gone, exposed pipes and ducts are damaged and sagging in places. A large plywood barrier covers the window opening.When the window tore off, Smalls says the staff worked quickly to evacuate some 20 patients to a safer part of the hospital. They couldn’t use the elevator in the middle of the storm, so staff transported patients from the fourth floor to the third floor using the emergency stairwells. “We literally took the patients on the mattresses, slid them down the stairs, down to the third floor, across the building and up onto the other side,” Smalls says. “We have a surgical unit which was not compromised and capable of handling patient care.”Eventually, all of the patients who were at Schneider during the storm were evacuated off of the island. But even as staff dealt with a host of problems, the hospital remained open. In the emergency room, which flooded badly from a leaky roof, Smalls says, “You probably had about 3 to 4 inches of water on the floor in here. I had pumps. I think we probably had 50 people in here at any given time just trying to evacuate as much water out of the facility.”Today, the hospital continues to provide surgery, labor and delivery care, radiology and lab services. But its cancer center, a $28 million facility, remains closed because of extensive storm damage. The hospital can now only provide limited services for patients requiring dialysis. Meanwhile, Schneider Medical’s sister center, the only hospital on St. Croix, the U.S. Virgin Islands’ other major island, suffered even more extensive damage to its operating rooms.Without adequate medical services available, Schneider Regional CEO Bernard Wheatley says most patients who evacuated St. Thomas have not been able to return. “It’s over 400 that have been transferred off island,” Wheatley says. “And to this day, we’re still transferring some patients, especially the ones requiring extensive length of stay.”Along with the lack of facilities, another major problem is staffing. Wheatley says he’s lost 150 of the hospital’s 600 employees — many of whom left the island after the storms destroyed their homes. “The sad part of it, we’ve lost a lot of nurses,” he says. “If you ask me right now, what’s my key entity in terms of shortages, from a clinical standpoint it would be the nursing staff.” Shanique Woods-Boschulte, who directs Schneider’s foundation says, “Every day we get one or two resignations.” After five months, Woods-Boschulte says, the daily struggle is wearing down many staff members. “The morale was really high after the storm because we saw what we were able to accomplish — no patients hurt,” she says. “But now things are trickling down and everyone is leaving a broken hospital and going home to a broken home.”Adding to the woes, the hospital is in desperate financial straits. Revenues are half of what they were because there are far fewer patients. The government-supported hospital is projecting a $7 million loss.With all the competing problems on the islands, CEO Bernard Wheatley says it’s not clear how much help the local government can provide. “The territory itself is projecting a $400 million loss,” he says. “They don’t have the hotel rooms, tourism is down. It’s just not the same island.”The U.S. Virgin Islands is now looking to Congress to help decide what to do about its battered hospitals. The local government is in talks with FEMA and the Army Corps of Engineers to determine whether the hospitals can be rehabilitated, or if new facilities will be needed. Copyright 2018 NPR. To see more, visit http://www.npr.org/.
Marilyn Bartlett took a deep breath, drew herself up to her full 5 feet and a smidge, and told the assembled handful of Montana officials that she had a radical strategy to bail out the state’s foundering benefit plan for its 30,000 employees and their families.The officials were listening. Their health plan was going broke, with losses that could top $50 million in just a few years. It needed a savior, but none of the applicants to be its new administrator had wowed them.Now here was a self-described pushy 64-year-old grandmother interviewing for the job.Bartlett came with some unique qualifications. She had just spent 13 years on the insurance industry side, first as a controller for a Blue Cross Blue Shield plan, then as the chief financial officer for a company that administered benefits. She was a potent combination of irreverent and nerdy, a certified public accountant whose smart car’s license plate reads “DR CR,” the Latin abbreviations for “debit” and “credit.” Most importantly, Bartlett understood something the state officials didn’t: the side deals, kickbacks and lucrative clauses that industry players secretly build into medical costs. Everyone, she had observed, was profiting except the employers and workers paying the tab. Now, in the twilight of her career, Bartlett wanted to switch teams. In her view, employers should be pushing back against the industry and demanding that it justify its costs. They should ask for itemized bills to determine how prices are set. And they should read the fine print in their contracts to weed out secret deals that work against them. The way health care works in America, most employers cede control of costs to their health insurers, the hospitals that treat their employees and the companies they pay to manage their benefits. The costs are a dense thicket that few employers feel equipped to hack through. So they don’t.This failure helps explain why Americans pay the highest health care costs in the world — and why the tab continues to increase, year after year. Employers fund these costs through employee compensation packages, so the math is typically bad news for workers: Rising health costs mean fewer wage increases and less take-home pay. Montana was no different.And so Bartlett pitched a bold strategy. Step 1: Tell the state’s hospitals what the plan would pay. Take it or leave it. Step 2: Demand a full accounting from the company managing drug costs. If it won’t reveal any side deals it had with drugmakers, replace it.Bartlett’s strategy would expose a culture in which participants fail to question escalating costs and the role each part of the health care industry plays in them. These little-seen aspects of the health insurance industry and the way Americans pay for medical care are the focus of an ongoing series from ProPublica and NPR. As Bartlett laid out her plan that day in July 2014 in a conference room in Helena, Sheila Hogan, then-director of the state’s Department of Administration, liked what she was hearing. They needed something radical. To her knowledge, no one had ever tried anything like this. Bartlett would be taking on some of the state’s power players: hospitals and health insurers — and their politically connected lobbyists. If her plan didn’t work, the state and its employees were in trouble. If it did, it could create a blueprint for employers everywhere.Bartlett knew employers have negotiating power that few of them use. The health care system depends on the revenue produced by the surgeries, mammograms, lab tests and other services it provides, and it can ill afford to lose it. Bartlett got the job. She would call the industry’s bluff.Ballooning medical costsEmployer-sponsored health benefits are almost as old as America itself. In 1798, John Adams, the second U.S. president, signed a law that took 20 cents per month from the paychecks of U.S. seamen to fund their medical care. After the Civil War, lumber, mining and railroad companies in the American West withheld money from employee paychecks to pay for doctors and hospitals.After World War II, such plans became mainstream. Today, about 150 million Americans get their health benefits through their employers. The industry is dominated by what some call the “BUCAH” plans – Blue Cross Blue Shield, UnitedHealth Group, Cigna, Aetna and Humana. Half a dozen health insurers currently sit near the top of the Fortune 500, with combined annual revenue of about half a trillion dollars. Despite the money at stake, many employers have, wittingly or not, deferred to the industry. Decisions about health benefit plans are usually made by midlevel human resources managers who may not understand the forces in the medical industry operating against them. They’re often advised by insurance brokers, who are traditionally funded by the industry. And they’re trying to keep the peace for employees — who demand convenient access to the care they need. It’s a recipe for inertia.The conventional wisdom is that insurance companies want to reduce health care spending. In reality, insurers’ business plans hinge on keeping hospitals and other providers happy — and in their networks — often at the expense of employers and patients. Employers often feel caught between rising costs and concern that changes they make will be bad for their employees, says Michael Thompson, president of the National Alliance of Healthcare Purchaser Coalitions, which represents groups of employers who provide benefits to more than 45 million Americans. And, he says, they rely on the advice of industry experts instead of digging into the details.”We have got to get control of this thing or it’s going to bring down the economy, our personal bankrolls and our wages,” he says. “It’ll cost jobs in the United States and it’ll bring down our public programs. This is not a small issue. It’s a huge issue.”But Bartlett soon discovered that it was easier to talk about pushing back than to do it. A showdown with Montana’s hospitalsBartlett arrived in Helena, the state capital, in fall 2014 as an outsider navigating a minefield of established relationships. From the start, she knew she would have to tackle the staggering bills from the state’s hospitals, which made up the largest chunk of the plan’s expenses. It wouldn’t be popular because they also made up a significant chunk of hospitals’ profitsMontana, like many large employers, self-funds its plan. That means it pays the bills and hires an insurance company or other firm to process the claims. More than half of American workers are covered by self-funded plans. As the boss in this arrangement, Bartlett assumed she would have access to detailed information about how much the plan, which was managed by Cigna, paid for procedures at each hospital. But when she asked Cigna for its pricing terms with the hospitals, Cigna refused to provide them. Its contracts with hospitals were secret, Cigna representatives told her. That didn’t sit well with Bartlett, she recalls. “The payer cannot see the contract,” she says, “but we agree to pay whatever the contract says we will pay.” A cumbersome querying process set up by Cigna allowed her to get individual claims and other limited information. But the company would only give her aggregate data, with things lumped together, to show what she paid each hospital. It was like telling a family trying to reduce its grocery spending that it could only see what it spent in a year, not a breakdown of what bread and fruit and other items cost at each market. When Bartlett continued to demand information, Cigna balked; it needed to balance what she wanted with keeping the hospitals happy. “I don’t see the need for a balance,” she recalls telling them. “I am representing the payer.” Cigna declined to answer questions about its relationship with Montana’s plan, but it said in a statement that it had prioritized the plan’s preferences and needs. Bartlett ultimately settled on a radical solution: The plan would set its own prices for the hospitals.In the illusory world of hospital billing, the hospitals typically charge a high price for a procedure, then give insurers in-network discounts. These charges and discounts might be different for each procedure at each hospital, depending on who has more leverage during negotiations. The discounts, however, are meaningless if the underlying charges aren’t capped. When Bartlett looked at a common knee replacement, with no complications and a one-night hospital stay, she saw that one hospital had charged the plan $25,000, then applied a 7 percent discount. So, the plan paid $23,250. A different hospital gave a better discount, 10 percent, but on a sticker price of $115,000. So, the plan got billed $103,500 — more than four times the amount it paid the other hospital for the same operation. Bartlett recalled wondering why anyone would think this was OK. Under Bartlett’s proposed new strategy, the plan would use the prices set by Medicare as a reference point. Medicare, the federal government’s insurance for the disabled and patients over 65, is a good benchmark because it makes its prices public and adjusts them for hospitals based on geography and other factors. Montana’s plan would pay hospitals a set percentage above the Medicare amount, a method known as “reference-based pricing,” making it impossible for the hospitals to arbitrarily raise their prices. Fed up, Bartlett ended the plan’s relationship with Cigna. Her battle to upend the status quo riled some employees of her own office, who complained that she was demanding too many changes. Some quit. Bartlett didn’t let up. That Christmas, the Cigna representative sent each employee in Bartlett’s office a small gift, a snow globe. Bartlett didn’t get one. But her ideas were exciting to Ron Dewsnup, the president of Allegiance Benefit Plan Management, a Montana-based subsidiary of, ironically, Cigna. Allegiance had been studying variation in hospital prices for years and had twice sent reports to Montana hospitals showing how their prices for the same procedures differed significantly. The company had also considered a reference-based pricing model, but it “didn’t have any employers that were serious about taking a stand,” Dewsnup says. Allegiance got the state contract and began by comparing what the plan paid the 11 biggest hospitals in the state with the Medicare rates. The cheaper ones averaged about twice the Medicare rates, the most expensive one about five times the Medicare rates. No one wanted to stiff the hospitals, but this was ridiculous, Bartlett recalls thinking. She determined the new rate for all hospitals would be a little more than twice the Medicare rate — still a lucrative deal, but a good starting point to get prices under control. The contracts would also prohibit a practice called “balance billing,” under which hospitals bill patients for whatever charges a health plan refuses to pay. It would mean a boost for some lower-cost hospitals. Now, she had to persuade the more expensive hospitals to take less. “You’re in or you’re out”Kirk Bodlovic, the chief financial officer of Providence St. Patrick Hospital in Missoula, remembers the day an entourage from the state health plan, including Bartlett and Hogan, arrived at his hospital. Bodlovic knew from Allegiance’s reports that St. Patrick’s prices were on the high side. But he wasn’t prepared for the ultimatum: If St. Patrick’s wanted to treat state employees, the hospital would have to accept lower rates. If it didn’t, the state would pay for its employees to travel to other hospitals. “You’re in or you’re out, basically,” Bodlovic says.The state’s demand set off a series of meetings within the Providence chain, which also operates in California, Alaska and the Northwest. It didn’t have a lot of leverage because Missoula is a two-hospital town. Its competitor, one of the lower-priced facilities, had already agreed to the deal. St. Patrick’s considered rejecting the deal. Bodlovic says that thought gives him heartburn to think about now, envisioning the wrath of doctors if some 3,000 state plan members had ended up at a rival hospital. And the hospital would have lost about $4 million in annual revenue. “That’s a good chunk of business,” he says. In their final analysis, he says, St. Patrick’s officials decided it was the “lesser pain” to accept the new contract than to be left out of the deal. While the state worked to get hospitals to sign new contracts, their CEOs and lobbyists plotted end runs, scheduling meetings with the governor’s office to propose alternative solutions. When they arrived for the meetings, they found that Bartlett had also been invited. She effectively blocked their ideas. Still, Bartlett had to get all the hospitals on board — or else. The new pricing was set to go live on July 1, 2016, and, with a month to go, six of the major hospitals were holding out. “I started to panic,” Bartlett recalls. During sleepless nights, Bartlett imagined thousands of state employees being forced to zigzag across the state for medical care or running up massive bills at noncontracted hospitals. She put together communication plans for members describing how they would need to travel to avoid certain hospitals.With her stomach in knots, she went on the offensive. She took a graph showing the variation in hospital prices to state legislators. Then she threatened to go public. She couldn’t name names because of contract restrictions, but she could tell the media that some hospitals’ prices were three times as high as others and let reporters figure out which ones were which. Five of the holdouts surrendered and signed the contract. “The hospitals didn’t want that out there,” she says. Only Benefis Health System in Great Falls, one of the higher-priced hospitals, refused. The hospital’s CEO told the local newspaper that “it was business for them and it was business for us.” The new plan went into place July 1, without Benefis as a contracted hospital. Bartlett ratcheted up the pressure one more time, calling in the Montana Federation of Public Employees. The union has hundreds of members in the Great Falls area, including Keith Leathers, who works as an investigator with the state’s child support enforcement division. Leathers has a young daughter with scoliosis, and he didn’t want to drive long distances to get her the care she needs. He readily engaged in the fight.”We have a regional medical facility here that’s supposed to be able to handle almost any medical problem, period,” he recalls thinking. “And I got to go out of town to get care because they want to charge more than anyone else?”Union leaders launched a campaign against the hospital. Leathers says he sent a postcard and made a phone call every day to the hospital CEO, the board members — anyone he could find in leadership. He urged them to accept the new rates. Hundreds of other employees from across the state did the same. Within a month, Benefis agreed to join the health plan. The hospital declined to comment for this story.Leathers says employers and workers should be protesting health care costs “over and over again” all over the country. “Are we going to wait until the health care system just crashes?” he says. When Bartlett took over the state health plan, it spent about $200 million a year. Bartlett’s team estimated that the new hospital pricing schedule saved the plan more than $17 million in the second half of 2016 and all of 2017 — almost $1 million a month. By 2017, a plan that state officials had predicted would go broke had turned itself around. And it’s projected to save an additional $15 million in 2018 without cutting benefits to employees or raising their rates. Exposing hidden drug dealsBut Bartlett had one more target in her sights: prescription drug costs. Health plans contract with separate companies, middlemen entities known as pharmacy benefit managers, to get members their medication. And everyone assured Bartlett the state’s pharmacy benefits deal was “state of the art.” But just like with Cigna, she insisted on examining it herself. That wasn’t easy because the pharmacy benefits were run through a cooperative arrangement with other health plans, including those of universities, school trusts and counties. The state plan anchored the co-op, and the other partners were happy with the arrangement. Bartlett knew that pharmacy benefit managers are notorious for including deals that boost their profits at the expense of employers. One of the common tricks is called the “spread.” A pharmacy benefit manager, for example, will tell an employer it cost $100 to fill a prescription that actually cost $60, allowing the pharmacy benefit manager to pocket the extra $40. The fine print in the contracts often allows it. The spread is widespread. A recent report by the Ohio state auditor noted that the spread on generic drugs had cost that state’s Medicaid plan $208 million in a single year — 31 percent of what it spent.Sure enough, when she got the contract, Bartlett found that the state plan had fallen victim to the spread. Pharmacy benefit managers also rake in dollars through rebates paid by pharmaceutical companies. Most health plans would assume that because they’re paying for the drugs, they should get any rebates. But pharmacy benefit managers often don’t disclose the size of the rebate, which allows them to keep some or most of it for themselves. When Bartlett pressed, she discovered the state wasn’t getting the full amount of its rebates. Montana was getting taken, but it put Bartlett in a touchy political situation. The co-op needed the state as a partner or it wouldn’t survive. Bartlett decided her allegiance was to the plan’s bottom line. She pulled out of the deal. “She wasn’t afraid of ruining her career or making people angry,” says Scott McClave, a consultant with Alliant Insurance Services who helped analyze the pharmacy benefit contract. Bartlett says it helped that she was near the end of her career and didn’t need to please people. “I’m 67, so I could give a s***,” she says. “What are they going to do, fire me? I’m packin’ a Medicare card.” Bartlett found a pharmacy benefit manager, Navitus Health Solutions, that would not take any spread and would pass along all rebates in full. The next year, the plan saved an average of almost $16 per prescription. It purchased a similar mix and volume of drugs in 2016 and 2017. But it saved $2 million on the spread. And its revenue from rebates jumped from $3.5 million to $7 million, Bartlett said. The savings continue to this day.In July of this year, her mission accomplished, Bartlett left her position as administrator of the state employee health plan. She now works for the office of the Montana insurance commissioner, which is taking on pharmacy benefit managers in a bigger way. But Bartlett also has a side gig as a guru to other employers across the country seeking to pay less for their health benefits. Her advice boils down to pushing back. “You’ve got to get in there and do it,” she says. So how are Montana’s hospitals after the price cut? Just fine, it appears. Bob Olsen, vice president of the Montana Hospital Association, says he has not heard hospital leaders say they are struggling under the new state contract. They have had “reasonable financial performance,” he says. But Bartlett’s legacy may be even greater. With the state’s model in mind, St. Patrick’s Bodlovic said Blue Cross Blue Shield of Montana, the state’s largest insurer, recently came calling. Now it wants a similar pricing arrangement. ProPublica is a nonprofit newsroom based in New York. Sign up to get ProPublica’s Big Story newsletter to receive stories like this one in your inbox as soon as they are published.You can follow Marshall Allen on Twitter: @marshall_allen. Copyright 2018 ProPublica. To see more, visit ProPublica.
Doctors who are opposed to abortions don’t have to provide them. Since the 1970s, a series of federal rules have provided clinicians with “conscience protections” that help them keep their jobs if they don’t want to perform or assist with the procedure. Religious hospitals are also protected. Catholic health care systems, for example, are protected if they choose not to provide abortions or sterilizations. Doctors who work for religious hospitals usually sign contracts that they’ll uphold religious values in their work. But as the reach of Catholic-affiliated health care grows, these protections are starting to have consequences for doctors who do want to perform abortions — even as a side job.Religious hospitals often prohibit their doctors from performing abortions — even if they do so at unaffiliated clinics, says Noel León, a lawyer with the National Women’s Law Center. León was hired about two years ago to help physicians who want to be abortion providers. They have little in the way of legal protection, she says. “Institutions are using the institutional religious and moral beliefs to interfere with employees’ religious and moral beliefs,” León says. This kind of legal argument, León says, may prevent doctors from providing care they feel called to offer. And since many clinics that provide abortions rely heavily on part-time staff, it may also prevent these clinics from finding the doctors they need to stay open. Dr. Kimberly Remski sought help from León when she was job hunting. She is a primary care physician but had always been interested in women’s health. When she first set foot in a clinic that provides abortions, she realized it was her passion. “A lot of the things we spend our time doing in training are monotonous, or you’re getting swamped in work,” she says. “I just remember leaving the clinic feeling like I was doing something really important.”She interviewed for a job as a primary care doctor with IHA, one of the largest physician groups in Michigan, in 2017. She says she was clear about her desire to work one day a week in an independent clinic that provides abortions. Part-time work is common for outpatient physicians, and Remski says the doctors she interviewed with were receptive. “I was very upfront. I told that them that was a special interest of mine. I wanted to be able to pursue it,” she says. She signed a contract, and started preparing for her move. Then she got a call that the offer was off. Remski learned that her potential employer was actually owned by a larger Catholic hospital network called Trinity Health, and it requires physicians to “provide services in a manner consistent with the Ethical and Religious Directives for Catholic Health Care Services,” according to her contract. And, she says, she was shocked to learn Trinity Health would also have had a say over how she spent her free time. IHA officials told her that she couldn’t work on the side as an abortion provider if she took the job, Remski says. Trinity Health had merged with IHA in 2010, part of a wave of mergers that has led to a net increase in Catholic ownership of hospitals. According to a 2016 report from MergerWatch, an organization that tracks hospital consolidation, 14.5 percent of acute care hospitals are Catholic-owned or affiliated. That number grew by 22 percent between 2001 and 2016, while the overall number of acute care hospitals dropped by 6 percent. And as Catholic-affiliated health care expands, says León, doctors increasingly encounter morality clauses that prohibit them from performing abortions.León says she has worked with at least 30 physicians and nurse practitioners from 20 different states who faced problems similar to Remski’s when they disclosed to their employers, or potential employers, that they planned to provide abortions. “They’re being told, ‘We can’t provide the care we went into medicine to provide,’ ” León says. “We shouldn’t be putting providers in the position of caring for their patients or keeping their jobs.”Representatives of IHA would not agree to a phone interview about Remski’s situation, but spokesperson Amy Middleton explained in an email that IHA “works hard with our physicians to enable them to pursue other positions.” But, she added, “outside work that interferes with a physician’s ability to serve patients or contradicts the organization’s practices could present a conflict of interest.”IHA physicians follow Catholic health care guidelines, Middleton wrote, which requires that physicians “not promote or condone contraceptive practices.” Dr. Barbara Golder, the editor of the Catholic Medical Association journal, Linacre Quarterly, says that language about morality is ubiquitous in contracts — and that it is reasonable that religious institutions might not want to be associated with abortion providers. “The person is seen primarily as Dr. X of Catholic hospital Y, and then it turns out that Dr. X of Catholic hospital Y is doing abortions on the weekends,” Golder says. “There’s sort of a cognitive dissonance about that. It’s in opposition to what Catholic health care is.”According to Lance Leider, a Florida attorney who has reviewed hundreds of physician contracts, it is “exceedingly common” for contracts, not just at religiously affiliated hospitals, to include language about the reasons an employer can fire a doctor, including but not limited to morality clauses.”There’s always a laundry list of things the employer can terminate the contract for,” Leider says. “There’s usually a catch-all. Anything that calls into question the reputation of the practice.” These clauses tend to be vague, León adds, which means employers can invoke them to prevent a wide range of activities, like political activity, controversial posts on social media or, in religious hospitals, physicians spending time at clinics that provide abortions. The restrictions may have ramifications not only for physicians but for many clinics that provide abortions. Smaller clinics may be staffed almost entirely with part-time doctors, and when they can’t find enough, they’re sometimes left unable to meet the demand for services. “We don’t have full-time doctors,” says Shelly Miller, the executive director of Scotsdale Women’s Center in Detroit, one of the clinics where Remski worked. “We really cannot afford to have a provider sit here all day and wait for patients to come in.” Through her involvement with the National Abortion Federation, Miller often talks with other directors of small clinics that provide abortions and sometimes other women’s health services. She says that many of her counterparts say they exclusively hire part-time physicians because they simply don’t need somebody full time. If more physicians are prohibited from part-time abortion work, it may put some smaller clinics out of business, Miller worries.It’s hard to know exactly how many of these clinics primarily use part-time staff, according to Rachel Jones, who studies the demographics of U.S. abortion services at the Guttmacher Institute, a family planning research organization. Ninety-five percent of abortions take place in clinics as opposed to hospitals, Jones notes, which may be more likely to utilize a team of part-time staff. León doesn’t have data to show how common it is for physicians to be threatened with termination for providing abortions. She guesses that doctors will either give up on providing abortions — or, like Remski did, look for a different job that allows them to. León spends much of her time speaking to groups of doctors about how to approach contract negotiation if they want to provide abortions. Ultimately, Remski says, she parted amicably from IHA, since “it felt like the wrong place for me.” She ended up finding a job at an urgent-care clinic in Michigan, which allowed her to work part time at three separate clinics that provide abortions. She has since moved to Chicago, where she also splits her time between providing abortions and primary care. “I was providing a service that was needed and necessary,” Remski says. “I realized it was something I really needed to do.” Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine. Copyright 2018 NPR. To see more, visit https://www.npr.org.
Campaigners have questioned a series of claims by the minister for disabled people that there have been substantial improvements to major government disability programmes.Justin Tomlinson, who was appointed to the post in May, spoke this afternoon (Thursday) to two separate audiences of disabled people and campaigners.He claimed there had been substantial improvements to the Access to Work (AtW) scheme, and in the programme to introduce personal independence payment (PIP).He also attempted to justify government plans to cut £29 a week from the benefits of new claimants of employment and support allowance (ESA) placed in the work-related activity group (WRAG) from April 2017.Tomlinson first addressed a joint meeting of the all-party parliamentary disability group (APPDG) and the all-party parliamentary group on learning disability in Westminster, before heading across London to speak at the annual meeting of Disability Rights UK.He told the APPDG there had been “clear improvements” to AtW, with his department “speeding up the process” and increasing awareness of the scheme among small and medium-sized businesses.He also said there had been a “dramatic turnaround” in the PIP claim system, with four times more assessors, 200 more assessment centres, centres opening for longer hours and “improved communications with claimants”.He later told the DR UK event that PIP had had a “terrible start”, with a “terrible claimant journey”, but that “we have transformed it”.But he said he was “not complacent” and would ensure that the reassessment process of 1.3 million people on long-term disability living allowance, now underway, would proceed in “a controlled and measured way”, with weekly checks on how the system was coping so that this final stage of the PIP roll-out does not “compromise quality”.He attempted to justify the WRAG cut – which will see £640 million a year cut from disabled people’s benefits – by highlighting that only one per cent of those in the WRAG find sustainable work every month.He said there was “no way of describing that as anything other than unacceptable”, and said later that the WRAG top-up “was not meant to be an income boost”.He said: “That was not the intention when it was brought in. It was to provide direct support to get you into work.”Tomlinson told the APPDG that eventually an extra £100 million a year of those WRAG savings would be spent on employment support for disabled people.But Tomlinson’s claims were repeatedly disputed by disabled people and disability organisations who attended the two events.Tom Hendrie, from Cheshire Centre for Independent Living, told Tomlinson at the DR UK event: “A number of members are concerned about the way changes to local authority funding, the end of the Independent Living Fund, changes to benefits, have all come together in a perfect storm.”He asked if Tomlinson would encourage ministerial colleagues to attempt an assessment of the cumulative impact of all of the government’s reforms and cuts.Andrew Lee (pictured), director of policy and campaigns at People First Self-Advocacy, said at the APPDG: “I hear a lot about the government wanting more people to be in work, but as a person with learning difficulties myself, my experience is actually that there are more and more barriers to employment for disabled people.“The way the changes to Access to Work are hitting people with learning difficulties is one thing I know.”He said cuts to social care had forced him to cut his work hours so he could support his disabled wife.Lee said: “We do not get any support with things like form-filling, so we are running around everywhere trying to find someone to help us fill in our benefits assessment forms.”Mike Smith, chief executive of the London disabled people’s organisation Real, and former disability commissioner at the Equality and Human Rights Commission, asked Tomlinson at the DR UK event why the need for a national AtW scheme did not also apply to the Independent Living Fund, which the government closed in order to pass its funding to local authorities.Tomlinson did not appear to answer that question.Rebecca, a young disabled woman who spoke at the APPDG meeting, described her own experiences of claiming ESA and the difficulty of finding work, and said that cutting WRAG payments “could make life even more difficult for disabled people”.She said: “I need the money. Without it, I struggle.”She added: “I applied for so many jobs but I keep getting letters back saying they cannot accept me. I think it’s because I have a disability.“I find it really hard to have to explain that I could actually do the work.”Victoria Holloway, co-chair of the Disability Benefits Consortium, told Tomlinson at the APPDG that there was “no evidence whatsoever” that cutting WRAG payments would incentivise disabled people to find work.She said the move would instead move them further from the workplace, could mean people were unable to meet their essential living costs, and might even put some people’s recovery from ill-health at risk.A Mencap representative later asked Tomlinson for the evidence that cutting WRAG payments would “incentivise” disabled people to find work.He failed to make any reference to such evidence in his reply, but appeared to claim that the “incentive” was the extra money that would be available for employment support for disabled people.Gordon McFadden, chair of United Amputees, raised concerns about the quality of PIP assessments, and said that one contractor had been advertising for paramedics to carry out the tests, in addition to physiotherapists, nurses and doctors.McFadden told Disability News Service after the APPDG meeting that he had supported two people, both of whom had had both their legs amputated and were still turned down for the enhanced mobility rate of PIP, and told their Motability vehicles would be removed. Both decisions were only over-turned after McFadden became involved in their cases.Asked at the DR UK event whether he would look again at the decision to slash the qualifying distance for the enhanced rate of PIP mobility support from 50 metres to just 20 metres, Tomlinson said the department had “incredibly bright medical advisors who advise on the way of doing things”.He added: “We feel, based on the advice we have been given, it is the right thing to do but I recognise that most of you in the room do not [share that view].”Natalie McGarry, the SNP’s disability spokeswoman, told Tomlinson at the APPDG that disabled people placed in the WRAG had “already been found not fit for work”, and she told him that the government had apparently “not learned anything” from its failure to carry out preparatory work before the introduction of the bedroom tax.She said: “You are making their lives significantly more difficult but you are not changing their conditions, the barriers to work, or the work for people to get into.” And Labour’s shadow minister for disabled people, Debbie Abrahams, told the DR UK event, after Tomlinson’s departure: “As much as the minister provided a relatively rosy picture, I do not quite see things as he did.”She said she believed the cumulative impact of the new welfare reform and work bill on disabled people would be “very severe”.
Disabled people’s rights have regressed in at least nine areas since the coalition government assumed power in 2010, according to a new report by the Equality and Human Rights Commission (EHRC).The report concludes that disabled people are still being treated as “second-class citizens” and that rights have regressed in many areas of society, while in others progress has stalled.The report says: “It is a badge of shame on our society that thousands of disabled people in Britain are still not being treated as equal citizens and continue to be denied the everyday rights non-disabled people take for granted, such as being able to access transport, appropriate health services and housing, or benefit from education and employment.”The report, Being Disabled In Britain: A Journey Less Equal, aims to provide comprehensive evidence on disability inequality in Britain, and calls on disability groups to use its findings to “strengthen their case for change”, and on the UK and devolved governments to use it to improve laws and policies.The report examines progress on education; work; standard of living; health and care; justice and detention; and participation and identity, and says that disabled people are experiencing “disadvantages” in all of them.But the commission has also told Disability News Service (DNS) that it believes there has been a regression in rights in at least nine areas since 2010.One of these areas is the right to independent living, including the disproportionate effect of the government’s welfare reforms on disabled people.The report says that social security reforms have had a “particularly disproportionate, cumulative impact” on disabled people’s right to independent living and an adequate standard of living.It repeats its previous calls for the UK government to carry out an assessment of the cumulative impact of its cuts and reforms on disabled people, a demand that disabled activists have been making since at least 2011.Across the UK, according to the report, 18.4 per cent of working-age disabled people were considered to be in food poverty compared with 7.5 per cent of non-disabled people.Disabled people over the age of 65 were twice as likely as non-disabled people in the same age group to be in food poverty.The report also says there is a “growing body of anecdotal evidence” that the government’s welfare reforms, including the work capability assessment (WCA), are causing “significant harm and distress, particularly to people with mental health conditions, and that in some cases being found ineligible for Employment Support Allowance has resulted in suicide”.It points to an investigation by the Mental Welfare Commission for Scotland, research by academics from the universities of Liverpool and Oxford, and two prevention of future deaths letters, written by coroners and discovered originally by DNS, all of which have linked the WCA to the deaths of benefit claimants with mental health conditions.Other areas where there has been regression in disabled people’s rights include social isolation, with fewer opportunities for some disabled people to participate in the community; housing, with some disabled people being forced to move from adapted properties into unsuitable accommodation as a result of the government’s “bedroom tax”; and in healthcare, including the inappropriate use of “do not attempt resuscitation” orders.Other areas of regression include the inability to challenge detentions under mental health and mental capacity laws; discriminatory school exclusions, and – in Wales – the failure to protect disabled pupils from bullying; and the impact of government reforms on protection from employment discrimination.The report warns that detentions in health and social care settings under the Mental Health Act are continuing to increase in England and Wales, with the number of detentions in hospitals rising from 46,600 in 2009-10 to 63,622 last year.The report also points to regression as a result of government reforms to legal aid in England and Wales, which it says have harmed disabled people’s access to justice in family law, housing, employment, debt and benefits cases.The report says there was a 54 per cent drop in employment tribunal claims on the grounds of disability discrimination between 2012-13 and 2015-16, following the introduction of tribunal fees of up to £1,200 across Britain in July 2013.In new analysis carried out for the report on the Office for Disability Issues’ Life Opportunities Survey, the commission found that the proportion of disabled people who found it difficult to access public services (health, benefits, tax, sport and leisure) rose from 37.9 per cent in 2009-11 to 45.3 per cent in 2012-14, compared to a rise from 26.2 per cent to 31.7 per cent of non-disabled people.The report also calls again on the government to reopen its Access to Elected Office fund, which offered grants to disabled people to pay for their additional impairment-related costs in standing for election as a councillor or MP, and has been lying dormant since the 2015 general election.This week’s report draws mostly on previously-published research and analysis – including seven DNS stories – but also includes new analysis of published data.David Isaac, the commission’s chair, says in the report: “The Equality Act 2010 has still not been implemented in full, the [UN Convention on the Rights of Persons with Disabilities] has not been incorporated into domestic law and policy, life chances for disabled people remain very poor, and public attitudes to disabled people have changed very little.”Commenting on the report, he added: “This evidence can no longer be ignored. Now is the time for a new national focus on the rights of the 13 million disabled people who live in Britain.“They must have the same rights, opportunities and respect as other citizens.“We must put the rights of disabled people at the heart of our society. We cannot, and must not, allow the next 20 years to be a repeat of the past.”When asked how the minister for disabled people responded to the watchdog’s conclusion that disabled people were still being treated as second-class citizens, that their rights had regressed in some areas, and social security reforms had had a “particularly disproportionate, cumulative impact” on disabled people’s rights to independent living and an adequate standard of living, a DWP spokesman said: “We are committed to ensuring that a disability or health condition should not dictate the path a person is able to take in life.“The UK is a world leader in this area and we are proud of the work we do to support people with disabilities and health conditions, to increase opportunities and tackle inaccessibility.“Not only do we spend over £50 billion a year to support disabled people and those with health conditions – more of our GDP than Japan, Canada and France – we also offer a wide range of tailored and effective support.“Our focus is on helping disabled people find and stay in work, whilst providing support for those who can’t.”But Liz Sayce, chief executive of Disability Rights UK, said: “This new report makes sombre and disappointing reading, and highlights the unfairness disabled people continue to face, day in and day out.“As a society, we say we want progress towards disabled people taking a full part in society; but instead we appear to be going backwards. “We need concrete plans from government, with outcomes measured regularly, to ensure we get back on track.“We welcome the EHRC report and are keen to work with them and others to tackle discrimination.”
2019 Entrepreneur 360 List Is your ISP Throttling Your Internet Service? 3 min read Next Article –shares Technology Brought to you by PCWorld David Coursey February 12, 2009 Add to Queue Learn about these new tools to measure boradband network performance. The only list that measures privately-held company performance across multiple dimensions—not just revenue. Is the speed of your company’s Internet connection being throttled back by your ISP? Unless you’re using a cable modem for your business Internet connection–and have Comcast or Cox as the provider–probably not. But, wouldn’t you like to know, just to be sure?By offering new tools to measure broadband network performance, developers at a Google-backed venture called Measurement Lab are putting pressure on all ISPs to stop limiting customer bandwidth, or at least to not do it in secret.While I don’t know of any small businesses that have run into throttling issues–in which your ISP slows your Internet traffic because they think you’re overusing bandwidth–it is surely possible. Particularly if you actually do occasionally download large files in the course of your daily business.If it’s happening, a new tool called Glasnost will ferret it out. Should you find you’re being throttled, please drop me a note and I’ll investigate. It’s possible, even likely, that there is a whole lot more of this going on than people think.The ISPs’ real targets aren’t businesses, but people playing bandwidth-intensive games and doing huge uploads/downloads using things like BitTorrent. Some ISPs appear to be slowing these bandwidth hogs’ traffic to protect the network for everyone else. The ISPs don’t like to talk about throttling, so we aren’t sure how common it is or what the thresholds are for setting it off.Net Transparency I think the ISPs ought to be up-front about what they are doing–surely a new experience for telcos and cable providers–and offer customers a way to buy the bandwidth they need for a reasonable price. Customers should be told if their traffic is being throttled and given options to have the block removed.Business users probably don’t run into bandwidth throttling very often. Most small businesses don’t generate all that much Internet traffic and, when we do, it is likely directed at a hosted Web or commerce site, not our small office network.However, as businesses embrace VOIP telephony, video conferencing, and other bandwidth hungry apps, the possibility of finding a governor placed on your traffic might increase. Especially if you’re not purchasing a premium business package from your ISP.For example, many small businesses have fairly large numbers of people sharing what is probably a too-limited Internet pipeline. If all these folks pick up their VOIP handsets or join a two-way video conference at once, there could be trouble.For those reasons, it’s probably a good idea for small businesses to run Glasnost at least occasionally, especially during peak network loading.It isn’t clear to me how serious a throttling problem that home-based workers face, except that they seem more likely to be dealing with the ISPs associated with throttling.I don’t have a problem with ISPs charging bandwidth hogs for the privilege. But, I think it should be done in the open based on usage limits that are published. Usage data, likewise, needs to be available to customers in real time so they can either be aware some of their traffic is being blocked or reduce their usage before throttling occurs.After 25 years covering technology, David Coursey is, at different times during the day, a writer, radio talk show host, animal rescue volunteer, ham radio operator, and small business owner. Write him at firstname.lastname@example.org . Apply Now »
Free Webinar | July 31: Secrets to Running a Successful Family Business October 7, 2015 3 min read Image credit: semsudinv | Foap Pandora Buys Ticketfly for $450 Million Learn how to successfully navigate family business dynamics and build businesses that excel. Lucy England Next Article –shares This story originally appeared on Business Insider The music-streaming service Pandora just made an interesting acquisition. On Wednesday the company confirmed it is paying “approximately” $450 million (£294) for the American ticketing agency Ticketfly.The news comes after a report from Re/code, said that Pandora “appears close” to acquiring the ticketing company.The two companies are joining forces to “create the world’s most efficient platform for connecting listeners with live shows from their favorite bands,” Pandora cofounder Tim Westergren wrote in a blog post. That means that Pandora listeners will start be getting a “personalized flow of local shows they love,” Westergren writes, and artists and venues will hopefully be able to sell more tickets because they’ll be getting access to Pandora users in their area.While Ticketmaster still dwarfs Ticketfly — as well as every other company in the ticketing industry — Ticketfly does pretty well and handles ticket sales for performances at smaller venues and clubs where fans can get an intimate live-music experience.Rather than just selling tickets, Ticketfly’s platform also handles marketing and analytics for the venues it serves. Ticketfly sold $500 million (£326 million) in tickets in 2014.The deal $450 million pricetag is “a nearly equal balance of cash and stock,” Pandora said in a press release. Ticketfly raised a $50 million (£32 million) Series D round last summer, which brought its total funding up to a reported $87 million.So far, Pandora has made all of its revenue from its radio-streaming service. It actually beat second-quarter revenue expectations thanks to solid advertising growth on its free, ad-supported tier, which grew 30% year-over-year. Its local advertising business increased by 67% as well.The music-streaming service’s revenue clocked in at $285.6 million (£186 million) for the second quarter, just over the $283 million (£185 million) expected. But Pandora is still struggling with profitability because it has to pass along most of its revenue to music owners, and it actually lost $16.1 million (£10.5 million) overall in Q2.In a statement, Pandora CEO Brian McAndrews said: “This is a game-changer for Pandora – and much more importantly – a game-changer for music … Over the past 10 years, we have amassed the largest, most engaged audience in streaming music history. With Ticketfly, we will thrill music lovers and lift ticket sales for artists as the most effective marketplace for connecting music makers and fans.” Acquisitions Add to Queue Register Now »
Reviewed by James Ives, M.Psych. (Editor)Apr 1 2019Despite many successes, modern medicine is still struggling to find effective treatments for serious pathologies such as cancer and neurodegenerative and inflammatory diseases. For Alzheimer’s disease, for example, only 30% of patients respond to therapy whereas for cancers the figure is only 25%.‘The real bottleneck is not the absence of an efficient drug but the difficulty of making it reach the therapeutic target,’ says Francesco Nicotra, coordinator of the EU-funded NABBA project. ‘Many therapeutic targets are shielded behind biological barriers, limiting the possibility to reach them with conventional drugs or diagnostic probes.’The body’s defense system has several mechanisms for eliminating ‘non-self’ substances. This is even more problematic for most innovative biological pharmaceuticals, such as recombinant proteins, antibodies and gene therapeutics.Although the project has only just finished, the results are promising and the commercialization of one discovery has already started.Evading body defensesThe challenge faced by the NABBA researchers, working in a consortium of six research institutes and five companies, was how to protect drugs until they can reach their destination in the body. Their solution is to encapsulate the active agent in a ‘nano-vehicle’ that can travel through the body unimpeded until it releases its payload of drugs.The NABBA project has developed nano-vehicles based on different auto-assembling molecules of natural and synthetic origin, such as liposomes and certain polysaccharides. Researchers designed the vehicles to be invisible to the immune system and equipped them to overcome the biological barriers while delivering a useful amount of drug to the right place in a controlled manner.Getting to the right place is itself a major challenge. For some cancers, the nano-vehicles are small enough to slip through fissures that occur in the walls of lymphatic vessels at the tumor site, a phenomenon already observed with other nano-drugs. In other cases, more active targeting methods are needed.Related StoriesArtificial DNA can help release active ingredients from drugs in sequenceScientists develop universal FACS-based approach to heterogenous cell sorting, propelling organoid researchResearch sheds light on sun-induced DNA damage and repair‘The most challenging goal was to promote a specific active targeting – in other words, the capacity to release the drug selectively where it is needed,’ explains Nicotra.NABBA scientists have been working on two approaches. In the first, different targeting agents – peptides, carbohydrates or antibodies – are attached to the surface of the nano-vehicles to act as ‘keys’ to gaining access to the target cells. In the second strategy, an ultrasound beam collapses the nano-vehicle when it has reached its destination; the drug is released only in that place and diffuses into the surrounding tissue.Hope for Alzheimer’s patients?‘We have obtained very interesting and promising results,’ says Nicotra, ‘in particular targeting different tumor tissues and brain pathologies – the blood-brain barrier is the most difficult biological barrier to overcome.’When might we see these results translated into effective treatments? Nicotra cautions that it can take 10 to 15 years and around EUR 2 billion for a newly discovered drug to come to market, with a high chance of failure. Yet a class of nanoparticles developed in NABBA is already being promoted by a new start-up company, Amypopharma. It plans to develop it as a treatment for certain nerve pathologies and, in the longer term, as a possible therapeutic against Alzheimer’s disease.NABBA was a four-year project funded through the EU’s Marie Skłodowska-Curie actions program, in which 12 early-stage researchers worked with experienced scientists not only to enhance their own knowledge and skills but also to contribute to the new and rapidly growing field of nanomedicine. Source:http://ec.europa.eu/research/infocentre/article_en.cfm?id=/research/headlines/news/article_19_03_29_en.html?infocentre&item=Infocentre&artid=50035
Related StoriesIt is okay for women with lupus to get pregnant with proper care, says new studyAMSBIO offers new, best-in-class CAR-T cell range for research and immunotherapyTAU’s new Translational Medical Research Center acquires MILabs’ VECTor PET/SPECT/CTThe study reports that crowdsourced data, collected by software applications like Google’s Waze, are highly correlated with conventional reporting data that are often costly to collect and suffer from reporting lag-time. The ability to use crowdsourced user-generated traffic data has several immediate clinical implications for treatment and mortality rates among motor vehicle crash victims as well as for improving efficiency around emergency department operations in the United States.”The potential is game-changing. Trauma surgeons could be notified earlier, diagnostic testing could be prioritized for crash victims, and blood and other life-saving equipment could be made available sooner,” said Chakravarthy. “These pre-hospital and hospital level resources, if activated sooner, could aid in increasing quality and rapidity of patient care and potentially reduce morbidity and mortality.”Every day, more than 100 deaths and 2.5 million emergency department visits result from motor vehicle crashes, making it one of the leading causes of death in the United States. Reducing ambulance and emergency department treatment response time for crash victims could dramatically save lives.Further research is needed on the integration of crowdsourced traffic data as a tool to monitor car crashes and reduce associated mortality, including the potential risks of implementing this approach.Source:University of California – IrvineJournal reference:Chakravarthy, B. et al. (2019) Crowdsourced Traffic Data as an Emerging Tool to Monitor Car Crashes. JAMA Surgery. doi.org/10.1001/jamasurg.2019.1167. According to our research, it takes emergency medical service (EMS) units an average of seven to 14 minutes to arrive on scene after a 911 call. Crowdsourced traffic data might help to cut that time by as much as 60 percent.”Bharath Chakravarthy, vice chair of research and academic affairs for the UCI School of Medicine, Department of Emergency Medicine and one of the researchers on the study Reviewed by Alina Shrourou, B.Sc. (Editor)May 24 2019A new UCI-led pilot study finds, on average, Waze “crash alerts” occur two minutes and 41 seconds prior to their corresponding California Highway Patrol (CHP)-reported crash. These minutes could mean the difference between life and death.The paper titled, “Crowdsourced Traffic Data as an Emerging Tool to Monitor Car Crashes,” was published today in JAMA Surgery.
Discovery in Greece The two ancient skulls were unearthed in the late 1970s by researchers at the Museum of Anthropology at the University of Athens. Given that the skulls were found in Apidima Cave, the researchers named them Apidima 1 and Apidima 2. Both skulls, neither of which had a lower jaw, were found side by side in a block of breccia, angular pieces of rock that were cemented together over time. However, neither skull was in good shape; the damaged Apidima 1 included only the back of the skull, and at the time, researchers weren’t sure what species it came from. Apidima 2, which preserved the facial region of the skull, was identified as Neanderthal, but it was broken and distorted. For years, the skulls sat at the Museum of Anthropology in Athens until they were finally cleaned and prepared from the breccia block in the late 1990s and early 2000s. In the new study, Harvati and her colleagues put both skulls in a CT scanner, which generated 3D virtual reconstructions of each specimen. Then, they analyzed the features of each. As in previous analyses, the team concluded that Apidima 2, which had a thick, rounded brow ridge, was from an early Neanderthal. Identifying Apidima 1 was more challenging because of its fragmentary remains, but the researchers were able to create mirror images of its right and left sides, which gave them a more complete reconstruction. [In Photos: Oldest Homo Sapiens Fossils Ever Found] Several clues, such as the rounded back of the skull (a feature unique to modern humans), indicated that Apidima 1 was an early modern human, or Homo sapiens, the researchers said. Dating the skulls Next, the researchers dated the skulls. Previous analyses had estimated that the skulls were roughly from the same time period, given that they were discovered next to each other, suggesting that they lived around the same time. But by using a method known as uranium-series dating, the new team found that the skulls were not from the same time period. At 170,000 years old, the Neanderthal skull fit within the range of other Neanderthal remains found in other parts of Europe. But the modern human skull was an unexpected outlier, predating the next-oldest H. sapiens remains in Europe by more than 150,000 years, the researchers found. Uranium-series dating is one of only a few ways to date such ancient bones, “but it’s not without some pitfalls,” said Larry Edwards, regents professor in the Department of Earth and Environmental Sciences at the University of Minnesota, who was not involved in the study. In effect, the method works because uranium decays into thorium. The more thorium there is in a sample, the older it is, Edwards told Live Science. However, bones and teeth don’t contain much of their own uranium; rather, they absorb it from the environment over time. “That then requires you to make interpretations on how and when the uranium was picked up and whether or not the uranium was lost,” he said. But although this technique isn’t ideal for dating skulls such as Apidima 1 and 2, it can still provide useful data, Edwards said. “I think it’s pretty solid, their [dating] conclusions,” he said. Out-of-Africa implications Despite the skull’s title as the “oldest known modern human fossil in Eurasia,” the new finding does not rewrite the fundamentals of human evolution, said Eleanor Scerri, an associate professor and leader of the Pan-African Evolution research group at the Max Planck Institute for the Science of Human History in Jena, Germany, who was not involved in the study. Those fundamentals are that humans first evolved in Africa and then ventured out into the rest of the world. “The oldest human fossils still come from Africa and are about 100,000 years older than the Apidima fossil,” Scerri told Live Science in an email. “That is roughly 4,000 generations — ample opportunity to move around.” That said, “if we want to ask questions specifically about the early history of our species in Eurasia, then this study may confirm the arguments made for multiple, early dispersals,” Scerri said. In addition, this finding supports the view that the population of “early Homo sapiens was fragmented and dispersed,” she said. [Top 10 Mysteries of the First Humans] Previous studies have suggested that “Homo sapiens left Africa every time the Saharan and Arabian deserts shrunk, which happened broadly on 100,000-year cycles,” roughly agreeing with dates from this study, she noted. What’s more, if modern humans truly had reached Eurasia by at least 210,000 years ago, then “we can no longer assume that ‘Mousterian’ stone tool assemblages found across large regions of Eurasia are necessarily being produced by Neanderthals,” she said. There are many avenues open to researchers hoping to learn more about the Apidima skulls. For instance, the skulls could contain ancient DNA or primordial proteins that could verify their species, Eric Delson, who was not involved with the research, wrote in an accompanying perspective published online today (July 10) in the journal Nature. Delson is a professor and the chair of the Department of Anthropology at Lehman College and The Graduate Center at the City University of New York. Moreover, researchers could study the cave’s paleo-environment and climate to figure out what conditions were like when Apidima 1 and 2 lived there. Today, the cave is on a cliff facing the sea, reachable only by boat, Harvati said. The study was published online today in the journal Nature. A prehistoric, broken skull is revealing the secrets of ancient humans, divulging that early modern humans left Africa much earlier than previously thought, a new study finds. The skull, found in Eurasia and dating back 210,000 years, is the oldest modern human bone that anthropologists have discovered outside Africa, the researchers said. This skull, however, had an unusual neighbor: a 170,000-year-old, possibly Neanderthal skull that was found resting next to it, in a cave in southern Greece. Given that the Neanderthal skull is a solid 40,000 years younger than the modern human skull, it appears that this particular human’s early dispersal out of Africa failed. There are no living descendants of this enigmatic human alive today, and this person’s group was replaced by Neanderthals, who later lived in that very same cave, the researchers said. [Photos: See the Ancient Faces of a Man-Bun-Wearing Bloke and a Neanderthal Woman]These Sharks Were Too Busy to Notice a Bigger Predator Watching ThemThe unexpected twist at the end of this feeding frenzy delighted scientists.Credit: NOAA Office of Ocean Exploration and Research, Windows to the Deep 2019Your Recommended PlaylistVolume 0%Press shift question mark to access a list of keyboard shortcutsKeyboard Shortcutsplay/pauseincrease volumedecrease volumeseek forwardsseek backwardstoggle captionstoggle fullscreenmute/unmuteseek to %SPACE↑↓→←cfm0-9接下来播放Headbutting Tiny Worms Are Really, Really Loud00:35关闭选项Automated Captions – en-US facebook twitter 发邮件 reddit 链接https://www.livescience.com/65906-oldest-modern-human-skull-eurasia.html?jwsource=cl已复制直播00:0002:2802:28 “We know from the genetic evidence that all humans that are alive today outside of Africa can trace their ancestry to the major dispersal out of Africa that happened between 70[,000] and 50,000 years before present,” study lead researcher Katerina Harvati, a professor of paleoanthropology at the University of Tübingen in Germany, told reporters at a news conference. Other earlier modern-human dispersals out of Africa have been documented at sites in Israel, including one based on the discovery of a 194,000- to 177,000-year-old modern human jaw from Misliya Cave and others tied to early human fossils dated to about 130,000 to 90,000 years ago at the Skhul and Qafzeh caves. But “we think that these early migrants did not actually contribute to modern humans living outside of Africa today, but rather died out and were probably locally replaced by Neanderthals,” Harvati said. “We hypothesize this is a similar situation with the Apidima 1 [the newly dated modern human skull] population.” In Photos: Bones from a Denisovan-Neanderthal Hybrid Originally published on Live Science. This is the oldest known modern human skull in Eurasia, dating to about 210,000 years ago. Here, you can see the partial skull (right), its virtual reconstruction (middle) and a virtual side view. Credit: Copyright Katerina Harvati/Eberhard Karls University of Tübingen Photos: Newfound Ancient Human Relative Discovered in Philippines Photos: Looking for Extinct Humans in Ancient Cave Mud